2020 SCHOLARSHIPSStudent’s full name:

Address:

Phone number: Date of birth: / /

Sex: Male Female

Parents’ / guardians’ full names and occupations:

Name:

Occupation:

Name:

Occupation:

Primary school details:

Current primary school:Year 7 teacher’s name(s):Applying for:(Tick one or more)

Academic Scholarship Cultural Scholarship Sporting Scholarship

I agree to the conditions as set out in the scholarship offer, and will abide by the panel’s decision. I submit that the information in my application is true and accurate.

Applicant’s signature:

Parent’s signature:

Parent’s signature:

Primary school principal’s signature:

Completed submissions must be handed to your primary school principal by Friday, 20th September 2019 .

SPORTING SCHOLARSHIP – STUDENTStudent’s name:

Sports played (include representative level or grading level, e.g. Rugby League – Mackay Schools Under 12):

Describe your most outstanding sporting success so far.

Which sporting person do you most admire and why?

Outline your sporting ambitions for the next 5 years.

What training do you currently do for your sport(s)?

Forward your application to your primary school principal. Your primary school principal will complete Page 3 of the application and forward the completed application to Pioneer State High School.Applicants should also include a 200 word essay on their sport, their abilities and their sporting goals.

SPORTING SCHOLARSHIP – PRINCIPALStudent’s name:

Please rate the applicant on each of the scales below:

Average Above average Outstanding ExceptionalParticipation

Sportsmanship / etiquette

Natural talent

Drive to succeed

Sporting goals / aspirations

Training persistence

Team contribution

Academic ability

On a scale of 1 to 10 rate this student on his/her sporting ability and potential and briefly explain why.

Scale: ________

Special sporting skills or potential exhibited:

Personal characteristics / attitude:

Any further comments, including feedback from sports coaches or other relevant staff:

Principal’s name:

Principal’s signature:

After completing this page, please also complete Page 4 if there are multiple applicants from your school in this scholarship category. Please forward the completed application to Pioneer SHS.

SPORTING SCHOLARSHIP – COMPARISONWhen there are multiple applicants from a primary school applying for the same category of scholarship, the primary school principal should complete this form and forward it to Pioneer SHS with the completed applications.

Primary school:

Rank order of applicants:

Exceptional 10

9

8

Outstanding 7

6

5

Above average 4

3

2

Average 1

Additional comments:

Principal’s name:

Principal’s signature:

Please forward completed applications in confidence to:

The Principal, Pioneer State High School, PO Box 8279, Mt Pleasant 4740

Marked “Scholarship Application”

Applications should be submitted to primary school principals by Friday, 20th September 2019, and should be forwarded to Pioneer SHS by Wednesday, 9th October 2019.